Posterolateral Corner Of Knee Research Articles

Nonsurgical Management of Lateral Side Injuries of the Knee

Non-surgical management of posterolateral corner (PLC) knee injuries is reserved for specific isolated mild to moderate injuries. There has been a relative scarcity of studies discussing non-surgical management existing secondary to the relative rarity of isolated PCL injuries. In these specific cases, a few studies have shown non-surgical management to result in satisfactory outcomes. This review of the literature outlines the outcomes and treatment options for posterolateral corner (PLC) knee injuries, which is based on the grade of the injury. However, no matter what the grade of injury, it is crucial to rule out other associated deficiencies before undertaking a nonoperative approach in the management of the posterolateral corner of the knee.

Posterolateral corner reconstruction using a hamstring allograft and a bioabsorbable tenodesis screw: description of a new surgical technique.

Capsuloligamentous posterolateral corner knee joint deficiencies cause increased anterior cruciate ligament forces during internal knee rotation and increased posterior cruciate ligament forces during external knee rotation. Undiagnosed posterolateral corner knee joint injury in combination with anterior cruciate ligament or posterior cruciate ligament injury can lead to failure of anterior cruciate ligament or posterior cruciate ligament reconstruction. The purpose of this technical note is to present a new posterolateral corner reconstruction technique for treating patients with chronic capsuloligamentous posterolateral corner deficiency. The technique uses a bioabsorbable tenodesis screw and a hamstring allograft to reconstruct the popliteofibular and lateral collateral ligaments.

Anterior rim tibial plateau fractures and posterolateral corner knee injury.

The aim of this study was to review MRI findings of clinically suspected posterolateral corner knee injuries and their associated internal derangements. Sixteen knees in 15 patients who had evidence of a posterolateral corner knee injury on the physical exam underwent MRI to evaluate the posterolateral corner of the knee and to look for associated injuries. Two musculoskeletal radiologists reviewed the scans. Surgery was performed on 10 of the knees. Tibial plateau fractures were present in 6 knees; 5 of the fractures were anteromedial rim tibial plateau fractures. The popliteus muscle was injured in 13 knees and the biceps femoris in 6 knees. The lateral collateral ligament was ruptured in 12 knees. The posterior cruciate ligament was completely ruptured in 7 knees and avulsed from its tibial attachment in 1 knee. Eleven knees had a complete anterior cruciate ligament rupture. The anterior cruciate ligament was edematous without complete disruption of all fibers in 3 knees. There was excellent correlation between the MRI results and operative results in regard to the presence of a posterolateral corner injury of the knee (9 of the 10 knees had a posterolateral corner injury). In our study MRI readily detected posterolateral corner injuries. Posterolateral corner injuries of the knee are frequently associated with a variety of significant injuries, including cruciate ligament tears, meniscus tears, and fractures. Fractures of the peripheral anteromedial tibial plateau are not common; however, given their relatively common occurrence in this study, they may be an indicator of a posterolateral corner injury to the knee.

Reconstruction of the Posterolateral Corner of the Knee

ABSTRACT The following article outlines the historical perspective, indications, and operative technique for reconstruction of the posterolateral corner knee. We prefer a fibular-based reconstruction utilizing a semitendinosus autograft to reconstruct the stabilizing structures of the posterolateral corner. Although the anatomy of the posterolateral corner is complex, we believe that reconstituting the lateral collateral ligament and the popliteus-popliteofibular complex effectively restores the varus and rotational stability afforded by the posterolateral corner. Advantages to this technique include the limited dissection and decreased surgical time compared to other procedures. In addition, the procedure does not significantly disrupt the anatomy of the posterolateral corner, and hence can be used to augment a primary repair of the posterolateral structures.

Sonographic imaging of the posterolateral structures of the knee: Findings in human cadavers

Purpose: To evaluate and characterize the use of sonography in imaging the posterolateral structures of the knee in human cadavers. Type of Study: In vitro laboratory investigation using human cadavers and sonography. Methods: Three cadaver knees were dissected to expose the posterolateral corner with the skin and subcutaneous tissue removed. The iliotibial band, biceps femoris muscle and tendon, lateral gastrocnemius tendon, the lateral collateral ligament, the popliteus tendon, the popliteofibular ligament, the arcuate ligament, and the fabellofibular ligament (when present) were identified. Following the soft tissue dissection, sonography was performed to characterize these structures. The technique was refined using this “open” examination method as anatomical and structural detail was noted. After adequate familiarization with this technique, researchers performed sonography on 2 pairs of thawed fresh-frozen cadaver knees, 1 pair with a fabella and 1 pair without a fabella. After sonographic examination of all of the posterolateral structures, the knees were dissected and the structures previously identified by sonography were verified. Results: In all 4 cadaver specimens, all posterolateral structures were identified based on their imaging characteristics and surrounding bony and soft tissue landmarks. We also present dissection photographs and sonographic images depicting our study findings. Conclusions: Sonographic imaging may provide the clinician with valuable information regarding the posterolateral structures of the knee. To our knowledge, this is the first study to investigate the sonographic findings of these structures. This technique may assist the physician evaluating these injuries and help in preoperative planning for repair or reconstructive procedures. Further research is needed to determine the accuracy of sonography in identifying injured posterolateral corner knee structures in vivo.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 8 (October), 2002: pp 872–881